Picture this. The house is finally quiet. The children are asleep, the television is off, and you put your head on the pillow. That is when it arrives: a thin, high whine, like a mosquito that never lands or an old television left on in another room. Nobody else can hear it. And the harder you try to ignore it, the louder it seems to become.
A sound that begins in the ear and lives in the brain
Tinnitus is the experience of hearing a sound, such as ringing, hissing, buzzing or humming, when no outside sound is present. It is common, and for some people it becomes a constant, exhausting companion.
It often starts with a change in the ear. Years of loud noise, a single very loud bang, an ear infection, a build-up of wax, certain medicines or the ordinary hearing loss of ageing can all reduce the signals the ear sends to the brain.
The part of the brain that receives and makes sense of sound is called the auditory cortex. When it stops receiving the input it expects at certain pitches, it does not simply go quiet. One widely held explanation is that the brain turns up its own sensitivity to make up for what is missing, and the nerve cells in that area become more active on their own. That extra activity is thought to be heard as sound. This is why tinnitus is sometimes called a phantom sound, in the same way that a person may still feel a limb that is no longer there.
Why some people suffer and others barely notice
Two people can have tinnitus of the same loudness, and one will shrug it off while the other cannot sleep. The difference is thought to lie largely in how the rest of the brain responds.
The brain has an alarm system that scans for danger. If it labels the ringing as a threat, attention can lock onto it. The body tenses, sleep becomes light, and stress rises. Stress and tiredness can then make the sound more intrusive, and a loop is formed.
You may not be able to choose whether the sound is there. With practice, the brain may learn to stop treating it as an emergency.
Get your ears and hearing checked first
Tinnitus should always be assessed medically before anything else. Start with your GP, who may refer you to an audiologist for a hearing test or to an ear, nose and throat specialist. If hearing loss is found, hearing aids can ease tinnitus, possibly because they give the brain back some of the sound it was missing.
See a doctor urgently if you have any of the following:
- Sudden loss of hearing in one or both ears. This needs urgent attention.
- Tinnitus in one ear only
- A sound that pulses in time with your heartbeat
- Tinnitus together with spinning dizziness, facial weakness or numbness
- Tinnitus that began after a head or neck injury
- Distress so severe that you feel hopeless or have thoughts of harming yourself
Neurofeedback is complementary to this care. It does not replace a hearing assessment, hearing aids, sound therapy or the counselling approaches that are well established for tinnitus.
Where neurofeedback may fit
Neurofeedback is a non-invasive form of brain training. Small sensors placed on the scalp read your brain's electrical activity. Nothing is sent into the brain. When your brain shifts towards a calmer, steadier pattern, you get feedback through a tone or a picture on a screen. The aim is that, with repetition, the brain learns the pattern it is rewarded for. Our article on how the brain learns through neurofeedback explains this more fully.
Neurofeedback has been studied for tinnitus, including training that encourages alpha, a brainwave linked to relaxed wakefulness. The reasoning is that a hearing system at rest may be a quieter one.
The evidence so far is limited and mixed. We cannot promise that the ringing will stop, and it would not be honest to suggest that neurofeedback fixes the ear or restores hearing. What it aims to do is help the nervous system regulate itself, which may change how the sound is experienced. Results vary.
What training involves, and what helps at home
Every client at our Krugersdorp practice begins with a 19-channel brain map, which takes about an hour and a half. Sessions after that last 45 to 60 minutes and start with a short check-in on how you are feeling. Our what to expect page describes the process.
At home, a few simple habits are commonly suggested for tinnitus:
- Avoid complete silence. A fan, soft music or nature sounds at a low volume give the brain something else to listen to.
- Protect your ears from loud noise at concerts, in workshops and when using power tools, without wearing earplugs all day.
- Guard your sleep, because tiredness makes tinnitus harder to bear. Our article on chronic insomnia and sleep spindles may help.
Common questions
Can neurofeedback cure tinnitus?
No, we cannot promise that. Neurofeedback does not repair the ear or restore hearing. It is a complementary form of brain training that may help the nervous system settle. The aim is for the sound to feel less intrusive and less upsetting, not to remove it. Results vary from person to person.
Will the sounds used in training make my tinnitus worse?
Neurofeedback gives feedback through sound or through pictures on a screen, so training does not have to rely on sound alone. If you are sensitive to sound, say so to any practitioner before you start, and speak up straight away if a sound feels unpleasant. If your tinnitus seems worse after a session, mention it to the practitioner and to your doctor or audiologist.
Do I still need to see an audiologist or ENT specialist?
Yes. A medical and hearing assessment should come first, because tinnitus sometimes has a treatable cause, and hearing aids can make a real difference when hearing loss is present. Neurofeedback works alongside that care. It is not a substitute for a proper examination of your ears and hearing.
Tinnitus can make quiet moments feel like something to dread. If your ears and hearing have been checked and you would like to talk about whether brain training might help, you are welcome to contact Irine for a conversation.
- tinnitus
- ear ringing
- auditory cortex
- hearing
- sound sensitivity
